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Pre-transfusion hb 9 or 10

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maha:
Hi everyone
What is an ideal pre-transfusion hb for a thal major? My pediatrician suggests an hb of 9 while the hemetologist said it is best at 10. For the past few months he has been tranfusing every four weeks and his pre transfusion has climbed from 5gm/dl to 8.1gm/dl. Our pediatrician has asked us to check his hb before we come the next time as she doesn`t want to transfuse if he is around 10.
maha

§ãJ¡Ð ساجد:
Hi,

I think it depends on the quantity and gap between transfusion period that the doctor selects.

I used to get 2 bags with a gap of 1 month when I was in KSA; They didn't Transfuse if the Hb was 10 or above.

Now here in Pakistan; at JSF I get 1 bag with a shorter gap (10-12 days as I've grown up) and they will transfuse at 10g/dl or above. Their stopping limit is 11g/dl

I think keeping Hb levels above 10g/dl all the time with less blood given frequently will ensure good health and less iron overload.

Zaini:
i think it should be around 9.5 to 10, not lower then that,i think it keeps child's bones in good shape,not letting bone deformation occur,and let child live a quality life.

ZAINI.

Andy Battaglia:
10.5 is considered to be the ideal Hb level to maintain. Below this, bone marrow activity increases rapidly. Even at 9, the bone marrow is about 2-3 times more active than normal. This means more potential for bone expansion and also more bad red blood cells for the spleen and other organs to filter out. It also means more chance for growth of extramedullary hematopoiesis, which are commonly found in conditions of chronically low hemoglobin levels. So, if at all possible, keep the Hb up.

maha:
Hi Sajid
You cannot go by the number of bags in KSA. This is the first time Hassan received 200ml, but the bags are always of varying quantity, sometimes it is 210cc, sometimes 260cc and this time it was 350cc. What a waste of blood ???My pediatrician suggests 12ml/kg every three weeks but we are comfortable with 15ml/kg every four weeks because his veins are very difficult to find. She is always open to suggestions so lets see what she says for a pre-transfusion hb of 10.5. First I will have to convince my husband though.
thankyou
maha

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